Innovation and Disruption

Optum360 helps providers and payers work together to resolve revenue cycle problems

March 2, 2020 2:00 pm

Advancing the revenue cycle in today’s tumultuous healthcare environment requires a new vision that looks beyond using incremental process improvements to resolve problems. Instead, providers and payers must collaborate around ways to innovate and change the industry more holistically.

“Although Optum360 started as a company that provided point solutions aimed at solving specific revenue cycle challenges, it has evolved to be much more than that,” says Paul Emerson, CEO of Optum360. “Today, we holistically improve financial performance for providers through clinical intelligence, unique payer alignment and rich content that together enhance the patient experience, ensure revenue integrity and prevent denials at their source.”

A key element in Optum360’s transformative approach is the multiple perspectives the company brings to any problem. “We explore where breakdowns between payers, providers and consumers are happening and apply tools and technologies to smooth communication and facilitate information sharing,” says Todd Gustin, president of Optum360’s technology solutions division. “We have a unique vantage point because we are strategically situated between payers, providers and patients. By enabling unprecedented levels of transparency and collaboration across stakeholders, we can simplify and streamline processes, resulting in a better experience for all.”

Promoting a Dare You 2 Move mindset

“As a company, we challenge ourselves every day to effectively apply our existing capabilities and develop new ones to help our clients tackle the complex problems they face,” says Emerson. “Driven by this commitment, we are constantly looking for new ways to innovate — and a key source of innovation is our employees. One of our top priorities is to engage our staff to think critically and strategically to help clients solve problems and drive measurable outcomes.”

A way that Optum360 fuels its employees’ creative energy is through an annual innovation award. Every employee is eligible to participate, and nominations are accepted from around the organization. Introduced five years ago, the award’s purpose is to highlight the employees’ critical role in solving problems for customers and reinforce that individuals can have a real and measurable impact on healthcare delivery.

“The award inspires employees to identify where help is needed, scope the problem and then develop and implement an idea to fix it,” says Gustin. “In some cases, the innovation takes the shape of an actual product that we market to customers. In others, it’s a process change that gets woven into day-to-day operations. What makes this award different is it is not meant to drive financial benefit for the company but to encourage client-focused problem solving at every level of the organization.”

The program embodies Optum’s culture that encourages all employees to be creative and think outside the box, with the goal of addressing longstanding or recurring issues that have plagued the industry. “Innovation is not left to a single team here, it’s part of the company’s fabric and culture,” says Emerson. “This mindset underscores our commitment and passion for disruptive thinking to not merely improve on the status quo but change it.”

About Optum360

Optum360® is working to create a healthcare financial ecosystem so seamlessly interconnected that it works better for everyone. Optum360® advances the entire revenue cycle by aligning payers, providers and consumers. We strategically sit at the center of the healthcare financial exchange, and our innovative approach brings together leading-edge technology, decades of experience, artificial intelligence, clinical information and analytics. We identify and seize opportunities to drive first-pass payments and billing accuracy, improve consumer financial engagement and eliminate denials for all stakeholders. Our engagement model includes technology solutions, managed services, and full end-to-end revenue cycle transformation to give our clients the greatest flexibility for improving revenue cycle performance. 


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